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9500 Portside Dr
All APPLICABLE INFO LISTBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: r ` Permit Number: m Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED INPROVEMENT LOCATION: Address-. Legal Description: Property Tax ID #: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: )Cr �t ^> CONSTRUCTION INFORMATION: Addi ona workto a performed under this permit— check a tat apply: _Gas Tank _Gas Piping _Shutters _Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: / Co nstruction: $ [�� Utilities: _Sewer _Septic Building Height: ��OWNE91_E SE CONTR CTOR: Name: l Addrr5s� Company: b / City. it State: �� Addre Zip Code: Fax: City: State:% No 7�' Zip Code: 3 Fax: rg`3 -il: Phone No.fee simple Title Holder on next page ( if different E-Mai . }he LE Owner listed above) I State or County License:i�if If value of ronstrurtinn;c 74nn .........e ., orr nnnrn .•_.__ _�.. - ��••� .vu�r us Cummencemenr is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND R AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." S re o Owner/ Lessee/Contractor as Agent for Owner ractor/License Holder STATE OF FLORIDA _ COUNTY OF Gc�n+ LOCI L STATE OF FLORIDA COUNTY OF L"Ct-IC, The fo going instru nt was acknowledged before me thisrdayof 6LIS� 20�by The fing instrument was acknowledged before me this:44,,rgodayof UST 20�by i esta, Dznn� Cttey&L Name of person making statement. Name of person makingstatement. `r Personally Known OR Produced Identification ' Personally Known // OR Produced Identification Type of Identification Type of Identification Produced Produced ),&, L 4Ar-4 Notary Pudic SteEe d otery P"Dlic Skte „� r• ( jgnature of Nota Public - St da�canm;sa an o03287D4 /� aw EzpireaOMyjj=pj3 Commission No. c'. j �, nature of Notar Pu c f " ( V isssionG 326704 aw Expirea09r2'?�"<U2;1 mission No. G G Sea REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Certificate of Product Ratings AHRI Certified Reference Number: 201872159 Date: 08-02-2019 Model Status : Active AHRI Type: RCU-A-CB Outdoor Unit Brand Name: AMERISTAR Outdoor Unit Model Number (Condenser or Single Package) : M4AC404201 Indoor Unit Model Number (Evaporator and/or Air Handler) : M4AH4E61 B1 COOAA Region : All Region Note: 1803 The manufacturer of this AMERISTAR product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (A2) - Single or High Stage (95F), btuh : 42000 SEER: 15.00 EER (A2) - Single or High Stage (95F) : 12.50 1"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale; OR new models that are being marketed but are not yet being produced.'Production Stopped' Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still sellino or offerin0 for sale. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered Into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on 'Verify Certificate" link lifc Ixtwe and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, which is listed above, and the Certificate No., which is listed at bottom right $- -- 132082273811087685; ©2019Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: